Individual
KELLY LEA BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 995-3442
Mailing address
4449 WOOLWORTH AVE, OMAHA, NE 68105-1756
(651) 341-9829
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16528
NE
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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